title: Performance of the novel Paediatric Yorkhill Malnutrition Score (PYMS) in hospital practice.
abstract: OBJECTIVE
  Nutritional screening in paediatric inpatients is important. However, there is a lack of validated screening tools for this population. In this study the development of a nurse administered paediatric malnutrition screening tool is described and its performance evaluated.
  
  
  METHODS
  The Paediatric Yorkhill Malnutrition Score (PYMS) rate BMI, weight loss, dietary intake and predicted effect of the current condition on nutritional status, with a score of 0-2 for each element. Patients with total score of 2 or more are referred for dietetic review. A four month pilot phase was conducted in three medical and one surgical wards of a tertiary hospital and the general paediatric ward of a district general hospital. Performance of the tool was assessed by auditing completion rates, yield, impact on dietetic workload, and by evaluating dietitians' feedback.
  
  
  RESULTS
  1571 patients (72% of admissions) were screened of whom 158 (10%) scored at high risk. Non-screened children were younger and had a shorter length of hospital stay. Of the 125 patients who scored at high risk, between the 2nd and 4th month of the pilot, 66 (53%) were assessed by a dietitian of whom 86% were judged to be at true risk of malnutrition and 50% of these were new to the dietetic service. Dietetic workload did not increase significantly during the pilot phase although the proportion of referrals from the acute receiving wards increased. Dietitians' feedback was positive, with recognition that PYMS identified patients at risk of malnutrition who may not have otherwise been referred.
  
  
  CONCLUSIONS
  Nutrition screening by nurses using the new PYMS score is feasible for paediatric inpatients, identifies children at risk of malnutrition and uses available resources efficiently.
authors.affiliation: Women and Children Directorate, NHS Greater Glasgow and Clyde, Glasgow, UK. k.gerasimidis@clinmed.gla.ac.uk
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Gerasimidis
authors.forename: Isobel
authors.initials: I
authors.lastname: Macleod
authors.forename: Anne
authors.initials: A
authors.lastname: Maclean
authors.forename: Elaine
authors.initials: E
authors.lastname: Buchanan
authors.forename: Paraic
authors.initials: P
authors.lastname: McGrogan
authors.forename: Isabel
authors.initials: I
authors.lastname: Swinbank
authors.forename: Mary
authors.initials: M
authors.lastname: McAuley
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Wright
authors.forename: Diana M
authors.initials: DM
authors.lastname: Flynn
mesh_terms: D002648:Child; D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002664:Child Nutritional Physiological Phenomena; D004046:Dietetics; D005260:Female; D006767:Hospitals, District; D006776:Hospitals, Pediatric; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D010865:Pilot Projects; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015431:Weight Loss